Insurance Verifier

Insurance verification and authorization

• Verify insurance eligibility and benefits for assigned inpatient and observation accounts.
• Re-verify coverage when patients transition into a new calendar month.
• Review and update insurance information accurately in Meditech Expanse.
• Identify discrepancies in coverage, subscriber information, coordination of benefits, and registration data.
• Review payer requirements for inpatient admissions, observation stays, and specialty services.
• Obtain, review, document, and track prior authorizations and inpatient notifications.
• Monitor authorization status and ensure extensions or updates are obtained in a timely manner.
• Communicate authorization concerns, delays, or denials promptly.

Account review and communication

• Conduct daily account audits to identify missing or incorrect insurance information, coverage termination issues, authorization deficiencies, registration inaccuracies, and incorrect patient class or financial data.
• Report workflow or registration errors to leadership for corrective action and process improvement.
• Escalate high-risk accounts that may impact reimbursement or patient care.
• Collaborate with registration, financial counseling, case management, utilization review, nursing units, and patient financial services.
• Provide timely updates regarding insurance or authorization barriers.
• Assist departments with payer requirement clarification and insurance-related questions.

Documentation and compliance

• Maintain complete, accurate, and timely documentation within Meditech Expanse.
• Ensure compliance with hospital policies, payer regulations, HIPAA guidelines, and departmental workflows.
• Meet productivity and quality standards established by leadership.

Minimum qualifications

• One or more years of insurance verification experience.
• High school diploma or equivalent.
• Ability to communicate effectively and in a timely manner.
• Ability to work closely with other departments to ensure timely reimbursement.
• Flexibility to support rotating coverage needs, including weekdays, weekends, and holidays.

• Competitive wages
• Comprehensive benefits program for employees and their families
• Employment with an independent, nonprofit, faith-based acute care community hospital
• Opportunity to support a new state-of-the-art hospital development at the Focal Point Community Campus